The Bush Doctor's Challenge

Please, don’t. Abby didn’t say it, but she definitely thought it!

Stay calm. Abby mentally steadied herself making her way over and gently helping a groaning Shelly onto the floor. There’s a clinic two minutes away filled with nurses, equipment… Her mind flashed to her doctor’s bag winging its way across the outback, a doctor’s bag with artery forceps and umbilical clamps and, luxury of luxury, latex gloves. For that split second she could have cheerfully strangled Kell with her bare hands.

‘I’ll get Kell to ring the clinic,’ Abby said assuredly, pushing herself up from the floor, but Shelly’s hand grabbed her arm as she shook her head, her face purple as she started to bear down.

‘It’s coming now!’

‘Then we’d better get on and deliver this baby’ Abby soothed, her voice amazingly calm given her rapid heart rate. ‘We’ll manage just fine.’

Grabbing a handful of folded towels, Abby took a deep steadying breath. She hadn’t delivered a baby for years.

Years!

Even then it had only been a token attempt, with registrars and midwives beside her in a delivery room packed with equipment! Still, she reassured herself, fast labours were normally easy, just a steadying hand to help Mother Nature along. But as she examined Shelly Abby’s heart sank and Shelly’s question reiterated Abby’s findings from her brief assessment.

‘Is the baby still breech?’

‘Yes,’ Abby’s said, in what she prayed was a confident voice, as Shelly let out a moan of terror.

‘I thought it had turned. I said to Ross this morning—’

‘Shelly,’ Abby broke in firmly, ‘the baby’s going to be fine. I just need you to listen carefully to what I’m telling you to do.’ Her eyes shot up to her new patient and she forced a smile. ‘I’m going to shout for Kell. He can get someone over with a delivery pack, so try not to push just yet.’

‘What if I can’t stop myself?’

Abby took a deep steadying breath then looked up at Shelly, her smile every inch the confident emergency doctor she was. ‘Then we’ll deal with it.’

‘Kell!’

It wasn’t exactly a dulcet summons but, given that the television was still blaring and no doubt he was still playing housemaid, Abby wasn’t exactly left with much choice.

‘What’s up?’

He strolled into the laundry and to Abby’s bemusement he didn’t even look remotely fazed by the sight that greeted him.

‘Ring the clinic,’ Abby said through gritted teeth, as the baby’s buttocks descended lower in the birth canal, Shelly’s agonised screams splitting the hot afternoon air like a knife.

He returned moments later, pulling open a large leather bag, and Abby nodded her thanks as he handed her a pair of gloves and started to open a large paper-wrapped pack. ‘Did you ring?’

‘Yep, Clara’s on standby’ Kell said as Abby’s eyes widened in horror.

‘I don’t want Clara to be on standby,’ she hissed as loudly as she could without alarming Shelly. ‘I want her to send a team.’ Hell, why didn’t this Neanderthal just do as she asked? Yes, she was a doctor but this was a complicated delivery. Beads of sweat were on her brow as she struggled to stay calm. Why was Kell still here? Shouldn’t he do the polite thing and go and boil some water or something?

‘I’ve got to push,’ Shelly begged, and as the baby moved further down the birth canal Abby wasn’t sure what terrified her the most—the thought of a breech birth with no back-up or the fact Kell was pulling on a pair of gloves.

‘We are the team, Abby,’ Kell said in low tones, bending down so that only she could hear. ‘This as good as it gets here.’ His voice changed then, coming out lighter and friendly, as he looked up and smiled at Shelly. ‘The little one’s still bottoms up, Shelly, so I’m just going to move you.’

To Abby’s stunned amazement, in one quick motion he scooped Shelly up as easily as if she were a child and deposited her gently on the laundry bench. Then, pulling a basket over, he kicked it upside down and pushed Abby’s shoulders firmly down till she was sitting. As the fog cleared from her shell-shocked brain Abby realised Shelly was actually in the perfect position for a breech delivery.

‘You’re a nurse?’ Abby muttered, as the baby edged ever closer.

‘And a midwife,’ Kell whispered, guiding her hand to take the weight of the buttocks now being delivered. ‘You never said.’

‘You never asked.’

There wasn’t time for a smart reply. Shelly started to groan in earnest now, her frightened screams filling the small laundry. ‘I want Ross!’

‘He’ll be here soon, Shelly.’ Kell’s smile was far more effortless and, Abby realised, far more reassuring than hers.

‘I wanted him to be here!’ Shelly’s voice was rising as another contraction gripped her, and with a grunt that defied her tiny frame she bore down, but seemed to change her mind halfway, her arms flailing in agony, panic overwhelming her. Breech deliveries required a supreme maternal effort combined with concentration and Abby looked up anxiously, worried by Shelly’s lack of focus, knowing she needed her onside here.

‘Shelly, listen to me…’ Abby started, but a warm hand on her shoulder halted her in mid-sentence and she briefly turned her anxious eyes to Kell, who nodded assuredly.

‘She’ll be fine,’ he mouthed, then turned his attention to the restless woman. ‘Shelly, Ross is on his way, and we all know how much you need him right now, but holding back until he gets here isn’t the right thing to do. This little one isn’t waiting for anyone, so you need to do what Abby says and stay with us, OK?’

There was an air of authority in his laid-back voice, an assurity that to this point had been missing from the room, and Shelly responded to it.

‘I’m just scared.’

‘Why?’ Kell asked easily. ‘Abby’s got it all covered. You and the baby are both going to be fine.’

There was a strange pecking order in medicine. The fact Abby was a doctor supposedly overrode Kell, and, given that she had started the delivery, if Kell were to rush in and take over it could, by some, be seen as professional discourtesy. But at that moment Abby would have very happily given up her seat on the upturned basket and willingly handed the reins to a far more experienced midwife. This was not the welcome she had expected, and Abby took a deep, calming breath trying to quell the mounting panic inside her before the next contraction came and they set to work again.

‘All right?’ Kell checked, and Abby felt both embarrassed and strangely pleased that he seemed to sense her trepidation.

‘I hope so,’ Abby mouthed, and then suddenly it was her turn to benefit from his rather dazzling smile.

‘You’ll be fine, too,’ he said quietly as Shelly pushed for all she was worth as Abby and Kell shouted encouragement. With the lower trunk of the baby delivered, Shelly had a welcome break for a moment or two, but there was no time for Abby to relax. She checked a loop of the cord and nodded to Kell, the steady pulsing of the cord reassuring her that the baby wasn’t in distress, but she had the shoulders to deal with next and then the hardest part, the head.

‘OK, let’s go.’ Kell sounded as enthusiastic as he had when he’d started his bike as the next contraction started.

Abby felt a surge of confidence. Surely if Kell wasn’t worried she must be doing OK. One strong hand assisted her, gently pushing Abby’s hand, guiding her to deliver the baby’s shoulder downwards towards the floor. Suddenly Abby felt in control, the textbooks, the deliveries she had observed springing into her mind like a much-watched video. The shoulders were out now and she cast a quick glance up to Kell.

‘Hold steady a moment, Shelly.’ Coming round to Abby, he guided her arm to the infant, so that the baby was effectively straddling Abby’s forearm with its arms and legs. ‘Just let it hang for a moment,’ Kell said gently, and Abby gave a grateful nod, the weight of the baby allowing gravity to help with the delivery of its head. His hand was back on hers now, guiding her middle finger into the infant’s mouth as Abby used her other hand to increase the flexion of the head.

She drew the body of the babe first downward and then forward, the baby over Shelly’s abdomen as the last inches of the birth canal were negotiated, until finally, with a relief that literally overwhelmed Abby, the head was out, the baby was out and safe, taking a huge breath, its little eyes blinking in indignation as it was delivered. Abby placed the slippery bundle on Shelly’s stomach, whose hands moved down to scoop the babe up to her, tears streaming down her face as Kell rubbed the stunned little baby vigorously with a towel.

‘A little girl,’ she gasped. ‘I’ve got a little girl.’

‘A beautiful little girl, too.’ Kell’s words were coming out almost as choked as Shelly’s and to Abby’s amazement she watched as a sparkle of tears flashed in his dark eyes. ‘Look how blonde she is—she’s her father’s daughter all right.’

‘And she’s OK?’

Better than OK. One little girl was pinking up before their very eyes as Kell continued to rub, her dark red lips parted to allow a furious scream to escape.

As Kell dashed off to find a duvet Abby clamped and cut the cord, the placenta delivering with satisfying ease. Wrapping a bundle of towels around the baby and a large bath sheet around a shivering Shelly, she stood for a moment, just revelling in the sheer and utter miracle of birth.

‘Abby.’ Kell was at the door, only his face peering around as he pushed the duvet through the gap. ‘Cover Shelly up, I’ve got a little guy here who’s woken up with a bit of a fright.’